Frequent Oral Diseases in HIV Positive and AIDS Patients

Dr. Heddie O. Sedano, DDS

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Other Fungal Infections in HIV Positive and AIDS Patients

Several other opportunistic fungal infections have been reported in patients which are HIV positive, but the majority of these infections have been actually reported in AIDS patients and with very low CD4 cell count (> 200 cells per cubic mm.) (1-14). Most of the fungal infections have affected the lung, central nervous system, skin, esophagus, maxillary sinuses and ocassionally the oral cavity and perioral regions (4,5,7,8,11,12,13). After candidiasis, cryptococcosis is the most frequently observed fungal infection in AIDS patient (2). Most cases of histoplasmosis, blastomycosis and coccidioidomycosis occur in areas where these fungi are endemic, i.e. southwestern United States and Central and South America (2,6,10,14). Occasionally intraoral, large chronic ulcers have been found to harbor mycotic granulomas (8). The treatment of these infections is generally in the hands of physicians and generally consists of systemic administration of itraconazole or in more severe life-threatening infections amphotericin B followed by life-long maintenance therapy with fluconazole (2,3).

  1. Addrizzo-Harris DJ; Harkin TJ; McGuinness G; Naidich DP; Rom WN. Pulmonary aspergilloma and AIDS. A comparison of HIV-infected and HIV-negative individuals. Chest. 1997; 111:612-8.
  2. Ampel NM. Emerging disease issues and fungal pathogens associated with HIV infection. Emerging Infectious Diseases. 1996; 2:109-16.
  3. Bradsher RW. Histoplasmosis and blastomycosis. Clinical Infectious Diseases. 1996; 22 Suppl 2:S102-11.
  4. Hicks MJ; Flaitz CM; Cohen PR. Perioral and cutaneous umbilicated papular lesions in acquired immunodeficiency Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics. 1997; 83:189-91.
  5. Manfredi R; Mazzoni A; Cavicchi O; Santini D; Chiodo F. Invasive mycotic and actinomycotic oropharyngeal and craniofacial infection in two patients with AIDS. Mycoses. 1994; 37:209-15.
  6. McNeil MM; Ampel NM. Opportunistic coccidioidomycosis in patients infected with human immunodeficiency virus: prevention issues and priorities. Clinical Infectious Diseases. 1995; 21 Suppl 1:S111-3.
  7. Monteil RA; Hofman P; Michiels JF; Loubiere R. Oral cryptococcosis: case report of salivary gland involvement in an AIDS patient. Journal of Oral Pathology and Medicine. 1997; 26:53-6.
  8. Piluso S; Ficarra G; Lucatorto FM; Orsi A; Dionisio D; Stendardi L; Eversole LR. Cause of oral ulcers in HIV-infected patients: a study of 19 cases. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics. 1996; 82:166-72.
  9. Shetty D; Giri N; Gonzalez CE; Pizzo PA; Walsh TJ. Invasive aspergillosis in human immunodeficiency virus-infected children. Pediatric Infectious Disease Journal. 1997; 16:216-21.
  10. Singh VR; Smith DK; Lawerence J; Kelly PC; Thomas AR; Spitz B; Sarosi GA. Coccidioidomycosis in patients infected with human immunodeficiency virus: review of 91 cases at a single institution. Clinical Infectious Diseases. 1996; 23:563-8.
  11. Souza Filho FJ; Lopes M; Almeida OP; Scully C. Mucocutaneous histoplasmosis in AIDS. British Journal of Dermatology, 1995; 133:472-4.
  12. Sutton FM; Graham DY; Goodgame RW. Infectious esophagitis. Gastrointestinal Endoscopy Clinics of North America. 1994; 4:713-29.
  13. Teh W; Matti BS; Marisiddaiah H; Minamoto GY. Aspergillus sinusitis in patients with AIDS: report of three cases and review. Clinical Infectious Diseases. 1995; 21:529-35.
  14. Wheat J. Histoplasmosis and coccidioidomycosis in individuals with AIDS. A clinical review. Infectious Disease Clinics of North America. 1994; 8:467-82.
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